Referral Form

At Aesthetic Smiles, we are always happy to welcome new patients into our practice. We offer a comprehensive range of treatments including cosmetic dentistry, TMJ treatment, Sleep Apnea & Airway, Myofunctional Therapy and general dentistry.


If you would like to refer a patient to Aesthetic Smiles, please fill out the form below or call our office at 503.643.9855 to schedule an appointment.

Services (check all that apply)